The Procedure Scheduling Representative II manages complex procedures, high-end ASC cases, first-level escalations, and eligibility exceptions, serving as the senior operational liaison across scheduling, eligibility, providers, and operations.

Remote in Maryland or New Jersey

Essential Duties and Responsibilities:

• Mandatory Communication
  • Conducts introductory call to patients for all assigned procedures. The first call is mandatory for all procedures. Additional calls are completed as needed based on professional judgment.
• Collaboration with Offshore Eligibility & Pre-Cert Team
  • Serves as the onshore liaison to the offshore eligibility and pre-certification team.
  • Reviews eligibility and authorization findings, clarify discrepancies, and assist in resolving escalations.
  • Independently re-verifies eligibility and benefits when discrepancies are identified to ensure accuracy prior to scheduling.
• Eligibility & Exception Support
  • Provides eligibility confirmation support when discrepancies, payer conflicts, or escalations arise.
  • Acts as a backup resource for same-day procedures, emergency procedures, and Medicare add-on procedures where rapid validation is required.
• CORE Responsibilities
  • Completes mandatory call(s) to patients within SLA.
  • Communicates authorization status and timelines.
  • Explains out-of-pocket costs and collect deposits (50% ? 10% minimum).
  • Finalizes scheduling once cleared.
  • Identifies potential escalations or patient fall out.
  • Documents all communication and escalate issues per policy.
  • Partners closely with offshore eligibility team to resolve discrepancies.
  • Performs secondary eligibility verification when required.
  • Serves as backup for same-day, emergency, or Medicare add-on procedures.
  • Serves as the primary point of contact for initial patient fallout, including patients expressing hesitation or intent to cancel a scheduled procedure.
  • Conducts a first-level retention conversation to understand patient concerns, address questions related to insurance, cost, or process, and provide appropriate education and reassurance to support informed decision-making.
  • When a patient elects not to proceed after initial outreach, escalates and sees the case through to closure by coordinating handoff to the Office Manager, Vice President of Operations for the designated area or appropriate clinical team member for further discussion or final disposition.
  • Exercises confidentiality in all areas, abiding by HIPAA rules and regulations.
  • Checks and responds to work e-mail on a regular basis throughout the workday.
  • Participates in and complete all required trainings and in-services.
  • Performs other duties as assigned.

Minimum Qualifications: